Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Exam 3 NUR113
Prematurity/Thermoregulation/SIDS
| Question | Answer |
|---|---|
| What ways do newborns lose heat? | Radiation Conduction Convection Evaporation |
| True or false: newborns have a 3x larger body surface area in relation to body mass | True |
| What can impact newborn thermoregulation? | >Immature thermoreg system >Immature immune system >Body cannot shiver >Heavily influenced by environment temp >Limited amount of subQ tissue |
| What can a low temp indicate in a newborn? | Infection |
| What helps newborns maintain their body temp? | Brown adipose tissue-protects vital organs from temp changes extra layer of tissue around heart, kidneys. insulation. Flexed body position helps decrease BSA to help keep warmer |
| What complications can occur when a newborn has hyper or hypothermia? | >Increased metabolic rate=uses glycogen stores quick=hypoglycemia >Increased O2 use = respiratory distress |
| What interventions can a nurse perform to maintain body temp of newborns? | Monitor temperature Hat over head Warmed feedings Swaddle Don’t overheat Increase room temperature(in 70s) |
| What is normal newborn temp? | 97.7-99.5 |
| What is considered a newborn fever? | 100.4 F |
| What is SIDS? | sudden death of an apparently healthy infant that remains unexplained after other causes have been ruled out through autopsy, death screen investigation, and medical hx review |
| True or false: SIDS can be predicted. | False; unpredictable |
| What are SIDS risk factors? | Preterm Low birth weight twins low APGAR Race-indigenous/Alaskan natives Gender-male Family hx Exposure to tobacco smoke Maternal smoking Sleeping position & environment |
| What safe infant sleeping guidelines? | Offer paci @ bed & nap time swaddle/sleep sack avoid exposure to ETOH, smoke, etc. Separate designated infant sleep surface(no co sleeping) Place on back Do not over heat (dress appro.) Sleep in same room for 1st 6mo encourage breastfeeding |
| What gestational age is considered preterm? | less than 37 wks |
| What’s the problem with babies being born prematurely? | Immature body systems, difficult transition from intrauterine to extrauterine life, more problems regulating temperature not suppose to be here so body systems are not ready |
| What are the risk factors for premature birth? | Socioeconomic level Maternal nutrition Lack of prenatal care Maternal HTN; substance use; infections; Age<20 Problems with placenta (abruption, etc.) Previous preterm PROM age <20 substance use Close pregnancies |
| What will a preterm infant look like? | Pink/ red; acrocyanosis/translucent skin Large head Skull bones pliable; soft nails Minimal ear cartilage No creases in palms or soles Undescended testes/prominent labia minora Weak cry; poor reflexes Flaccid body position Jerky movements |
| What initial care/assessment is done for preterm infants? | resuscitation for low HR, apnea, respiratory distress Clear airway RR, and HR Ballard score |
| What is a normal newborn respiratory rate? | 30-60 |
| What is a normal newborn HR? | 110-160 |
| What nursing interventions should be implemented for newborn premature infants? | Daily weights; strict I/O; prevent cold stress & heat loss; minimize stimulus; position head w/ slight hyperextend; swaddle; pacifier to prevent oral aversion; involve, support, teach parents |
| What are the 3 BIG problems for neonates? | Hypoxia, hypothermia, hypoglycemia |
| What does surfactant do? Why is it necessary? | keeps lungs from collapsing when inflated; inadequate surfactant causes atelectasis, increased work of breathing, respiratory acidosis, and hypoxemia |
| What cardiovascular & respiratory complications can occur in premature infants? | Apnea of prematurity; Patent ductus arteriosus; Respiratory distress syndrome; Anemia of prematurity |
| What does respiratory distress lead to? | respiratory failure |
| What is the treatment for Respiratory distress syndrome (RDS)? | Suction airway; ventilator support; thermoregulation; parenteral nutrition; monitor ABGs; administer surfactant (via ET tube) |
| What is apnea of prematurity? | cessation of breathing for 20 second or greater OR cessation of breathing less than 20 sec w/ cyanosis, low HR, or pallor |
| What gestational age commonly has apnea of prematurity? What are the causes? | >36wks; Immature neuro system, reflux, obstructive apnea |
| What is the treatment for cold stress/hypothermia? | Increase room temp; radiant warmer; skin probe; avoid cold surfaces; warm feedings; skin to skin if possible |
| What is different about the neurological system of a premature newborn? What complications can arise? | poorly developed gag, sucking, and swallowing schedules; intraventricular/intracranial hemorrhage, hydrocephalus |
| What is different about the immune system of a premature newborn? | decreases passive immunity; thin skin does not provide a good barrier; skin easily torn |
| What are some manifestations of neonatal infection/sepsis? | hypo/hyperglycemia; abd distention; apnea or respiratory distress, hypoxia; irritability,; seizure activity; temp instability; drainage (eye, umbilical); skin/color changes; tachycardia; poor muscle tone; lethargy |
| What is different about the GI system of a premature neonate? | incompetent esophageal sphincter; small stomach capacity; difficulty absorbing nutrients & digesting lactose; Ca & P deficiency; fatigue easily from sucking |
| What are some nutritional considerations for premature neonates? | begin feeding ASAP; advance feedings as tolerated; requires more protein than full-term neonate |
| How many calories should a preterm neonate get per day? | 95-130 mg/kg |
| What is the best indicator of fluid status? | weight |
| What methods of feeding are available for premature neonates? What do they require? | Breastfeeding-coordinated suck, swallow, breath pattern; controlled body temp; consistent weight gain; limit feed duration; Gavage-NGT bolus or continuous for those that cant breast/bottle; TPN-last resort for nutrition, requires central line |
| What is necrotizing enterocolitis (NEC)? | Inflammatory process triggered by ischemia or hypoxia which leads to cell death and necrotic patches in mucosa |
| What are the manifestations for NEC? | abd distention**; gastric residual**; bloody stool**; apnea; low BP; lethargy; poor feeding; decreases urine output |
| What is the treatment for NEC? | Discontinue all feeds at 1st sign; admin hydrate & TPN via IV; NG tube for abd decompression; IV antibiotics; measure abd girth q4h; surgery: removal of part of bowel and/or temporary colostomy |
| What long term needs would a premature neonate require? What would their healthcare team monitor for? | Discharge teaching, close follow up; developmenal delays(motor/speech/hearing loss) may not be noted until infant is older; long term health conditions; promote highest quality of life |
| What collaboration occurs in the care of neonatal infants? | ❖ Parents/caregivers ❖ Respiratory therapy ❖ Dietician ❖ Speech therapy ❖ PT/OT ❖ Neonatologist ❖ Pediatrician ❖ Other physician specialists based on problem ❖ Early intervention specialists ❖ Pharmacists |
| What are the manifestations of respiratory distress syndrome? | Tachypnea, nasal flaring, grunting, retractions, labored breathing, prolonged expiratory phase, crackles, cyanosis, unresponsive, apnea |
| What is needed to keep alveoli from collapsing? (Think CPAP) | positive pressure |
| When does the sucking, swallowing, and breathing reflex develop? | 32-34wks gestation |
| What are the risk factors for developing NEC? | Prematurity; Respiratory distress syndrome; Exchange transfusion; Asphyxia; Receiving enteral feeding; Infection; Immature GI perfusion/immune system |
| What is the difference between respiratory distress and respiratory distress syndrome? | Syndrome = no surfactant(soon after birth); regular can happen at anytime |
| How is heat lost through evaporation? | being wet when out of the water |
| How is heat lost through radiation? | being in the cold and losing heat that wya |
| How is heat lost through convection? | cold fan blowing on newborn or water source |
| How is heat lost through conduction? | when they touch something colder than their body temperature lose heat to that source |
| What is the biggest surface area/ area to lose heat for a newborn? | their head |
| What is the magic number for temperature? | 97.7 anything lower we need to intervene |
| What are some nursing interventions for a baby temp of 97.4? | skin to skin hat increase room temp swaddle radiant warmer last resort |
| What is always the first intervention for hypothermic baby? | skin to skin |
| Why should you always double check the temperature? | could be incorrect |
| Where are most SIDS babies found? | in their crib |
| When is the babies ability to suck/swallow? | 32 weeks gestation |
| Why are premies susceptible to trauma to the brain? | skull bones are not hard |
| What will a premies respirations be like? | on the higher end of normal |
| What nursing intervention can help keep the airway open? | hyperextension of the airway |
| Babies that cant eat by mouth should be offered what? | a pacifier to help prevent oral aversion |
| What is oral aversion? | wont learn to eat by mouth |
| How can an increase in metabolic rate effect premature baby? | drop BS heat loss resp distress |
| Why do we minimize stimulation of pre mature baby? | excessive handling can increase metabolic rate and calorie use |
| What does surfactant do? | lubricant in the lungs that keep the alveoli from collapsing and sticking to each other without surfactant there is no gas exchanges |
| What is premature anemia? | RBC being destroyed rapidly dont have iron stores |
| When do the babies iron stores get generated? | during the last few weeks of pregnancy |
| How does respiratory distress syndrome come on? | very quickly not a slow increase |
| How is respiratory distress syndrome treated? | administer surfactant |
| What causes respiratory distress syndrome? | inadequate surfactant |
| How is surfactant administered? | administered directly into the airway they would need to intubated |
| What is apnea of prematurity? | cessation of breathing for 20 seconds or greater less than 20 seconds with cyanosis, bradycardia, or pallor |
| What are the causes of apnea of prematurity? | immature neuro system reflex obstructive apnea |
| What causes obstruction apnea? | not hyperextending the neck |
| Why are neonate more susceptible to heat loss? | less brown fat less glycogen stores immature thermoregulation system |
| How are some ways heat loss happens from immature thermoregulation system? | thin permeable skin unable to vasoconstrict peripheral blood vessels due to temperature |
| How is the renal system of a premature neonate effected? | one of first organs to go will always excete the same amount dont have the ability to fluctuate unable to buffer acidosis or alkalosis low GFR excretion of drugs take longer |
| What medicine is used for neonatal sepsis? | gentomycin |
| How is the immune system effected by being born premature? | decreased passive immunity thin skin less of protective barrier skin easily excoriated |
| What does excoriated mean? | red cracked broken skin |
| What is meningitis? | seizure activity d/t immature blood brain barrier and infection spreading to spinal fluid |
| What are some infection s/s in neonates? | hypoglycemia abd distension apnea seizure activity poor tone temp instability |
| How is the GI system effected in premies? | difficulty absorbing saturated fats difficult absorbing lactose calcium and phosphorus deficiency incompetent esophageal sphincter require more protien than full term |
| How long should you feed a formula fed baby for? | no longer than 30 minutes |
| How long should you feed breast fed baby for? | no longer than 45 minutes |
| Why should you limit the time a premature baby feeds? | they start burning more calories than they are taking in so will be suplemented |
| What is the tube feeding method for babies called? | gavage feeding |
| When is TPN used for neonates? | when baby cant be fed through GI tract requires central line increases risk for infection |
| What is the first intervention for a baby with NEC? | stop the feedings |
Created by:
failingstudent88
Popular Nursing sets